Individual
JACK RYAN TAKAHASHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
975 SERENO DR # 218, VALLEJO, CA 94589-2441
(707) 651-1000
Mailing address
975 SERENO DR # 218, VALLEJO, CA 94589-2441
(707) 651-1000
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
A182209
CA
Other
Enumeration date
03/23/2021
Last updated
09/26/2025
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